The document is a job application form for the Assam State Urban Livelihoods Mission Society, requiring candidates to fill in personal details, educational qualifications, professional experience, and references. It emphasizes the need for a recent passport-sized photograph and the submission of self-attested copies of relevant documents. Candidates must declare the truthfulness of their information, with consequences for any false statements.
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
0 ratings0% found this document useful (0 votes)
18 views3 pages
Job Application Format
The document is a job application form for the Assam State Urban Livelihoods Mission Society, requiring candidates to fill in personal details, educational qualifications, professional experience, and references. It emphasizes the need for a recent passport-sized photograph and the submission of self-attested copies of relevant documents. Candidates must declare the truthfulness of their information, with consequences for any false statements.
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
Assam State Urban Livelihoods Mission Society
Job Application Form PAS)
ase read instructions carefully before filling the application | Siapio »
recent passport size
PLEASE FILL UP THE APPLICATION IN CAPITAL LETTERS IN OWN HANDWRITING colour photoaraph
(Except Signature, all information is to be filled up in CAPITAL LETTERS) size 35 mx
Fields marked as * are compulsory ‘The colour photo
NAME OF POST APPLIED FOR*:
DETAILS OF CANDIDATE Please your si
1. NAME OF CANDIDATE: photoaran
FIRST NAME:
MIDDLE NAME:
‘SURNAME:
2. FATHER’S NAME*:
3. MOTHER'S NAME*: I
4, CATEGORY (TICK \)*: GENS SCC sTC] OBC] «Mosc
5. GENDER (TICK ¥)*: MALE[—] FEMALE(_]
6, DATE OF BIRTH (DD/MMIYYYY)*:
7. AGE (as on 01-01-2017)": Years| Months| Days|
8, PERMANENT ADDRESS*:
9. ADDRESS FOR CORRESPONDENCE*: (If same as
District:
State: Pin code: Assam State Urban Livelihoods Mision Society EI
10. CONTACT NUMBER": Ei
(Candidate can mention two mobile nos.)
11, E-MAIL ID":
12, EDUCATIONAL QUALIFICATIONS":
ACADEMIC | QUALIFICATIONT NAME OF UNIVERSITY | GRADEIDIVISION
NAME OF COURSE | SCHOOL/COLLEGE/INSTITUTE | _/BOARD | [PERCENTAGE
SSC
Matriculation
Higher
Secondary /
Xil
Graduation
Post
Graduation
“Any Other
Qualification
(MPhil, Ph.D,
etc.)
13. PROFESSIONAL EXPERIENCE":
Employment details (Post Qualification only) (Candidates may use extra sheets if required and may
enclose as annexure)
DURATION
sl. From To Total | NATURE OF
No. | DESIGNATION | ORGANISATION | (D315) (Cate) th DUTIES
Months)
TOTAL EXPERIENCE (in months) =
14, TRAINING AND OTHER COURSES ATTENDED (If any):
Si. NAME OF TRAINING / OTHER NAME OF DURATION
No. ‘COURSE ATTENDED INSTITUTE From To Total (in
Months) Assam State Urban Livelihoods Mission Society (ERI
15. LANGUAGES KNOWN’: (PLEASE TICK ¥)
‘[Link]. | LANGUAGES WRITING READING ‘SPEAKING
English
1
‘Assamese
2
Hindi
3
16. NAME AND ADDRESS OF TWO PERSONS FROM WHOM WE MAY SEEK REFERENCE ABOUT YOU":
(The two persons must not be related to you and must have interacted with you in a Professional and / or
Academic capacity for more than 2 years)
si NAME THE DESIGNATION ‘ADDRESS ‘MOBILE Email -1D
No, REFERENCE NUMBER
(PERSON)
cI
2
17. This application form should be submitted along with self attested copies of:
a) proof of age, b) proof of educational qualifications (Mark sheets and Pass Certificates), c) work
experience certificates, d) caste certificate (if any), and other relevant testimonials and documents (with
self attestation)
DECLARATI
‘hereby declare that all the statements made by me in this application form are true and complete to the
best of my knowledge and I belief that nothing has been concealed or suppressed. | also understand t
in case, any of my statements are found untrue during any stage of recruitment, selection and thereafter, |
shall be disqualified for the post applied for and | shall be liable for any penal action by ASULMS/Govt. of
Assam.
Date: ‘Signature of the Candidate
Place: